Kim, Seong Heon;Park, Hee Ju;Park, Su Eun;Hong, Yu Ra;Lee, Young Ah;Shin, Jong Beom
Pediatric Infection and Vaccine
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v.14
no.1
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pp.43-46
/
2007
Purpose : Neonatal bacterial meningitis has been known that its mortality and morbidity is high and its neurologic complications are common. This study was performed to review of the etiology of neonatal bacterial meningitis in Busan, Korea. Methods : We retrospectively analyzed 21 medical records of patients who were diagnosed neonatal bacterial meningitis in four university hospitals in Busan from January 1997 to December 2005. We analyzed age at onset of symptoms, symptoms at admission, causative organisms, and complications. Results : There were 11 male patients and 10 female patients. One premature neonate was included. 7 patients had symptoms at 2-3 weeks after birth and 6 patients at 1-2 weeks after birth. 18 cases had fever, 8 cases had seizure and some had poor feeding, lethargy and irritability. The most common organism causing neonatal bacterial meningitis was Group B streptococcus (GBS). 11 cases were due to GBS, 3 cases due to E. coli, 3 cases were due to Klebsiella pneumoniae, and 2 cases due to Streptococcus pneumoniae. one Listeria monocytogenes and one Enterobacter cloacae were included. 18 patients were alive and 3 patients died. Mental retardation, developmental delay and epilepsy occurred in a living patient. Conclusions : Although this was a retrospective study, we found that Group B streptococcus (GBS) was the most common organism causing neonatal bacterial meningitis and this data is nearly same as others in the world.
This research was performed to investigate the possibilities of industrial usage of camellia (Camellia japonica L.) by examining the antioxidant and antimicrobial effects of methanol extract with different sections. Content of total phenolics, DPPH radical scavenging activities and antibacterial activity of young leaf, mature leaf, flower bud, flower, bark, and seed of camellia were compared in vitro experimental models. Total phenolics was contained the higher in young leaf (74.62 mg), flower bud (65.02 mg) and flower (62.42 mg) but less than 20.95 mg per 100 g of dry weight in other parts of Camellia japonica L. And effects of antioxidant measured by DPPH radical scavenger activity ($RC_{50}$, reduce concentration 50%), was shown higher $7.16{\sim}18.14\;{\mu}g/m{\ell}$ in methanol extract of young leaf, flower bud and flower than $61.23\;{\mu}g/m{\ell}$ of BHT as a chemical oxidant. Also, the antimicrobial activity of Camellia japonica L. extracts determined using a paper disc method against food-borne pathogen and food spoilage bacteria, the young leaves extracts showed the most active antimicrobial activity against 7 kinds of harmful microorganisms. Flower bud extracts showed the highest antibacterial activity against P. aeruginosa and Enterobacter spp. C1036. In addition, the minimum inhibitory concentration (MIC) of young leaf extract against B. subtillis,S. fradiae,S. aureus,E. coli,P. aeruginosa, Enterobacter spp. C1036, and S. typhimurium were revealed 1 to 15 ${\mu}g/m{\ell}$. As a result, antimicrobial activity of camellia extracts was shown higher gram positive bacteria than gram negative bacteria.
Purpose : Bacteremia in immunocompromised pediatric cancer patients can lead to high morbidity and mortality, if not treated early and properly. The incidence and antibiotic sensitivities to common pathogens of bacteremia in pediatric cancer patients are liable to change, according to region and time. We investigated the causative organisms and antibiotic sensitivities of bacteremia in pediatric cancer patients to assess the adequacy of empiric antimicrobial therapy. Methods : From September 1995 to August 2003, we retrospectively evaluated 58 episodes in 39 pediatric cancer patients with bacteremia treated at the Pediatric Department of Yeungnam University Hospital. We investigated and analyzed the causative organisms and the antibiotic sensitivity test results by reviewing the records of the microbiologically proven positive blood culture results. Results : The incidence of bacteremia in pediatric cancer patients in this study was 5.7 percent (58 episodes out of 1,022 occasions of blood cultures). Gram-positive organisms were isolated more often than gram-negative organisms (63.8 percent vs 36.2 percent) in the following order : Staphylococcus epidermidis (37.9 percent), Staphylococcus aureus (17.3 percent), Escherichia coli (12 percent), Streptococcus (8.6 percent), Enterobacter (6.9 percent), Klesiella (6.9 percent), Serratia (3.5 percent), Acinetobacter (3.5 percent), Proteus (1.7 percent) and Morganella morganii (1.7 percent). In antibiotic sensitivity tests, only six of 37 isolates (16 percent) of gram positive bacteria were sensitive to penicillin and 15 of 37 isolates (40 percent) were sensitive to oxacillin. All except one Staphylococcus aureus were sensitive to vancomycin and all except one Staphylococcus epidermidis were sensitive to teicoplanin among 37 isolates of gram positive bacteria. In the case of gram negative bacteria, two of 21 isolates (10 percent) and four of 21 isolates (19 percent) were sensitive to cefotaxime and ceftazidime, respectively. Only six of 21 isolates (29 percent) were sensitive to aminoglycoside, but all 21 isolates (100 percent) were sensitive to imipenem. All seven isolates tested after the year 2000 were sensitive to meropenem. Conclusion : In conclusion, we should choose the proper antimicrobials in treating pediatric cancer patients with suspected bacteremia, reflecting the increasing episodes of gram positive bacteremia and polymicrobial resistance of gram positive and negative organisms.
Lee, Yung Kwun;Lee, Hee Chul;Chun, Jung Mi;Yoon, So Young;Lee, Woo Gill;Shin, Son Moon
Clinical and Experimental Pediatrics
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v.48
no.7
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pp.760-765
/
2005
Purpose : We studied the changes in antibiotic sensitivity to the causative organisms of urinary tract infection(UTI), in order to provide useful information on the choice of adequate drugs in the treatment of UTI. Methods : We retrospectively analyzed the major causative organisms and their antibiotic sensitivities in 69 patients diagnosed with UTI in the Department of Pediatrics, Samsung Cheil Hospital from 2002 to 2003. Results : The frequency of UTI was the highest in infants younger than 1 year of age(88.4 percent). The male to female ratio was 3.05 : 1. Escherichia coli was the most frequent organism(78.3 percent), followed by Klebsiella(11.6 percent), Pseudomonas(2.9 percent), Proteus(2.9 percent), Enterobacter, Morganelle, and Enterococcus(1.4 percent) in descending order. Antibiotic sensitivity of gram negative organisms was above 90 percent against imipenem, amikacin, 80 percent against aztreonam, cefepime, ceftriaxone, 50-70 percent against gentamicin, trimethoprime-sulfamethoxazole (TMP/SMX), and 23 percent against ampicillin(23.4 percent). Conclusion : Antibiotict sensitivity of gram negative organisms was high to amikacin and third generation cephalosporins but low to ampicillin, gentamicin and TMP/SMX. The use of ampicillin or TMP/SMX, as the first choice of the empiric and prophylactic treatment for UTI, should be reconsidered and investigated further.
This experiment was carried out to evaluate the water quality in the lower part of the Nagdong river in Korea. Three hundred and sixty water samples were collected from the 15 stations from December 1981 to November 1982 by tide(see Fig.1). Water temperature, pH, chloride ion, salinity, total coliform, fecal coliform, viable cell count and the composition of coliform were observed to evaluate the water quality. The variations of water temperature was ranged from $2.0^{\circ}C\;to\;29.5^{\circ}C$ and as mean value from $15.8^{\circ}C\;to\;18.9^{\circ}C$. The range of pH was 6.00-8.88 and 7.20-7.96 as mean value. The concentration of chloride ion from St. 1 to 5 was higher as 17.51-771 mg/l in flood tide than 13.12-264.58 mg/l in ebb tide. Specially, water quality at St.1 (Samrangjin) which located about 46 km far from Hadan was also influenced by tide. Salinities of water in flood tide were a litte higher ($11.05{\sim}31.08\%0$) than those of in ebb tide ($7.80{\sim}29.28\%0$). Total coliform MPN's ranged from 3.6/100 m/l to 460,000/100ml. The geometric mean value of the upper area (included St. $1{\sim}3$) was $259{\sim}538/100ml$, that of the middle area (included St. $4{\sim}6$) was $1,097{\sim}39,544/100ml$ for it leveled heavy contamination. Specially, in the ebb tide St. 10 was influenced by St. 6 and 7. In the upper area, the geometric mean value of fecal coliform MPN's was $109{\sim}199/100ml$ but in the area in cluded St. 5, 6 and 7 were heavily contaminated by domestic sewage, waste water from the factories area and bird's excrement. Composition of coliform was $17\%$ Escherichia coli group, $33\%$ Citrobacter freundii group, $28\%$ Enterobacter aerogenes group and $21\%$ others. Plate count of samples was varied from <30 to $3.9{\times}10^4/ml$ during the study period.
As the consumption of environmentally friendly agricultural products increases, food safety is at the forefront of public health concerns. We analyzed the biological hazards of 26 species of leaf vegetables and 4 species of fruit according to types of cultivation (conventional or organic filming) and distribution system (giant retailers or organic food stores) using various culture media, automatic bacterial identification systems, and microscopy, Total bacterial count of unwashed agricultural product ranged from $5.2{\times}10^{3}\;to\;1.5{\times}10^{5}\;CFU/mL$ (from 0.1 g of agricultural products), and the average count dropped 25-fold (range, 8-60-fold) after water washing. Microbial levels of washed organic agricultural products were $6.0{\times}10^{2}-1.9{\times}10^{4}\;CFU/mL$, and were not significantly different f개m the microbial loads on conventionally farmed produce. There was no significant difference in bacterial count from agricultural produce purchased from giant retailers or organic food stores. Total microbial count of Chinese cabbage, welsh onion, red chicory and kale were comparatively high, and Enterobacter cloacae was isolated most frequently. Parasites were detected in agricultural products purchased from conventional farm products in the stores of giant retailers, and in organic food stores, and parasite prevalence was especially high in Chinese cabbages and welsh onion. The study indicated that cultivation methods and distribution systems did not cause significant differences in biological contamination levels of agricultural produce. Some vegetables and fruits were highly contaminated effective sanitizing methods to reduce these biological hazards are needed.
Background: Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications. Methods: A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated. Results: 1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(11%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methicillin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%. Conclusion: As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.
Background: In 1987, the British Thoracic Society (BTS) subjected an extensive list of patient variables to statistical analysis in a prospective study of prognosis in 453 adults with community-acquired pneumonia and, subsequently published guidelines for management of severe community acquired pneumonia. It was hoped that those at risk of dying from community acquired pneumonia could be easily identified and treated appropriately, thereby reducing mortality. To date, severe community acquired pneumonia has not been well studied in Korea. Therefore, we studied retrospectively 10 patients dying of severe community acquired pneumonia in Dongsan Hospital to see clinical manifestations of dying of severe community-acquired pneumonia. Methods: Between July 1987 and july 1993, 498 patients were admitted to Keimyung University Dongsan Hospital with community acquired pneumonia, and 77 of them received intensive care. Of the 77 patients, 10 patients died. We reviewed medical records of these patients. Results: 1) The mean age of the patients was 56.2 years(range, 25 to 75 years). There were 7 men and 3 women. Seven patients(70%) were older than 60years of age. 2) The clinical features on admission were as follows: tachypnca, hypoxemia, mental change, cyanosis, leukopenia, leukocytosis, azotemia, hypotension, hypoalbuminemia in order of frequency. Three patients had one abnormal physical finding, 3 patients had 2, 2 patients had 3, and 2 patients had none of these abnormal physical findings. All patients had at least one of the abnormal laboratory findings. 3) A potential bacterial pathogen was isolated in sputum culture from 2 patients. One was E.coli, the other Enterobacter species. Sputum stain were positive in eight cases (G(+)cocci in six, G(+) cocci and G(-)bacilli in two). 4) Features of respiratory failure were the main reasons for ICU transfer, but two patients were transferred only following a cardiac or respiratory arrest in the general ward. 5) The mean of 2.7 different antibiotics were given to the patients. The aminoglycoside and first generation cephalosporin were the most frequently prescribed antibiotics, followed by the third generation cephalosporin and vancomycin. The most frequently prescribed antibiotics combination was a 1st generation cephalosporin plus an aminoglycoside. 6) Seven patients death(70%) occured after admission within the first five days, and a mean duration of hospitaliztion was 11.2 days. Conclusion: As the results show most death occured within the first five days after admission and aged patients; consequently, an aggressive intensive treatment should be provided early to the patients with severe community acquired pneumonia, and we should pay more attention to the aged patients.
Kang, Min Joo;Shin, Hye Kyung;Yim, Hyung Eun;Je, Bo-Kyung;Eun, So Hee;Choi, Byung Min;Park, Jong-Tae;Eun, Baik Lin;Yoo, Kee Hwan
Clinical and Experimental Pediatrics
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v.49
no.3
/
pp.278-286
/
2006
Purpose : Although suprapubic bladder aspiration(SBA) is the most reliable technique for identifying bacteriuria in young infant, no report has been published about the clinical manifestations of urinary tract infection(UTI) diagnosed by aspirated urine in Korea. This study was performed to examine clinical manifestations and related factors of UTI confirmed by a positive urine culture obtained by SBA in young infants. Methods : We reviewed medical records of 159 infants younger than six months of age, who had been admitted for UTI to Korea University Ansan Hospital from January 2002 to June 2005. Results : The male:female ratio was 5.1 : 1. The most common pathogen in urine culture was Escherichia coli(92.5 percent). Most of the gram-negative pathogens had high sensitivity to amikacin, or third generation cephalosporins and had low sensitivity to ampicillin, trimethoprim-sulfamethoxazole, or gentamicin. Hydronephrosis and vesicoureteral reflux(VUR) were present in 32.7 percent and 27.7 percent respectively. Renal cortical defects observed on DMSA scans were detected in 37.1 percent. Prolonged fever duration and hospital day, high erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels, hydronephrosis and VUR were related to the renal cortical defects(P<0.05). Rates of UTI-associated bacteremia and aseptic meningitis were 8.3 percent and 6.6 percent. Conclusion : Early differential diagnosis is very important in infants younger than 6 months of age with UTI because the clinical findings are non-specific and UTI-associated bacteremia and aseptic meningitis are concomitantly found. Because prolonged fever and higher ESR and CRP levels are risk factors of the renal cortical defects, radiologic evaluations and nephrologic follow-up were needed in identifying the predisposing congenital abnormalities and chronic renal scarring.
Jo, Yun Ju;Lee, Eun Jeong;Choi, Kyong Min;Eun, Young Min;Yoo, Hwang Jae;Kim, Cheol Hong;Lee, Hyun Hee;Kim, Pyung Kil
Pediatric Infection and Vaccine
/
v.17
no.1
/
pp.30-35
/
2010
Purpose : We investigated the causative organism and its antibiotic susceptibility of community acquired urinary tract infection (UTI) in children at a secondary hospital to test the adequacy of the current guidelines. Methods : Children diagnosed with UTI at the Department of Pediatrics, Kwandong University MyMyongji Hospital by pyuria and bacterial growth of greater than $1.0{\times}10^5CFU/mL$ on clean catch midstream urine from January 2005 to December 2008 were studied retrospectively. The epidemiologic data, causative organism, and the antibiotic susceptibility were analyzed. Results : Sixty two children were diagnosed with sixty four cases of UTI's. Two bacteria were isolated in one case and thus data on 65 urine cultures were analyzed. The male:female ratio was 1.6:1 and 78.1% were less than 12 months of age. Escherichia coli was the predominant cause consisting of 53 cases (82.8%) of the cases. K. pneumoniae (5), Enterobacter (4), Enterococcus (1), $\beta$-streptococcus (1), Diphtheroides (1) were isolated. The antibiotic resistance of E. coli were as follows; ampicillin 69.8%, cefotaxime 1.9%, gentamicin 15.1%, amikacin 0.0%, levofloxacin 1.9%, and trimethoprim/sulfamethoxazole 26.4 %. Only one case of the E. coli was extended spectrum $\beta$-lactamase (ESBL) positive. Conclusion : Compared to prior reports from other tertiary hospitals in Korea, E. coli was the predominant cause in childhood UTI and the rate of ESBL positivity was low. The antibiotic resistance was also different compared to prior reports. We conclude that a difference in the cause and antibiotic resistance of childhood UTI exists between centers and this should be taken into consideration when prescribing antibiotics for childhood UTIs.
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